In 2006, the Centers for Disease Control and Prevention (CDC) formally recommended preconception care for both women and men.

Yet men are often overlooked when it comes to smoking cessation counseling, blood pressure screenings, weight management guidance and other preconception care services.

And the consequences can be dire.

In fact, even when mothers are in good health, a dad’s poor health can increase their odds of giving birth prematurely, delivering a low birth weight baby or developing serious complications like preeclampsia.

What are some of the roadblocks men experience accessing preconception care and how can they be addressed?

USF College of Public Health (COPH) researchers set out to answer those questions and more. Their study, “Assessing the Unmet Preconception Care Needs of Men in the United States by Race/Ethnicity and Nativity,” was published in March in the journal Sexual and Reproductive Healthcare.

“Since the CDC’s guidance on preconception care, much of our efforts within public health and medicine have been on improving women’s health status, behaviors and outcomes with little or no corresponding effort dedicated to these same factors for men,” Nicole Harris, a COPH doctoral student concentrating in community and family health and lead author of the study, said. “Programs, services and initiatives have historically characterized women’s health as the sole determinant of pregnancy, birth and infant health outcomes. With this study, we sought to get a baseline of the percentage of men in the U.S. who needed these services and who received this care.”

Harris and her co-authors, including COPH students Morgan Richardson Cayama, Caroline Arias, Fariah Ansari, Chinwendu Ilonzo, Allure Williams and faculty members Drs. William Sappenfield and Russell Kirby, found that some 64 percent of men were in need of preconception services yet many of them, particularly those who identified as Hispanic or were foreign born, faced barriers to receiving it.

For example, the study found that foreign-born men had significantly higher odds of not receiving preconception counseling regarding HIV or sexually transmitted infections. Hispanic men were less likely than white or Black men to receive blood pressure or smoking screenings.

“There could be several potential reasons for these findings,” said Richardson Cayma, who is seeking her PhD with a concentration in community and family health. “They may have an inability to access or pay for services, transportation issues, experience discrimination or provider disrespect and/or difficulty navigating the fractured U.S. health care system.”

Other factors noted by the authors include providers having difficulty receiving insurance reimbursement for men’s preconception care, having a misunderstanding of who should provide the care (for example, a primary care provider or a urologist) and a skepticism that it improves pregnancy outcomes.

And even when care is rendered, it’s sometimes substandard.

 “The quality and timing of services still need to be studied, even within the women’s preconception care literature,” Richardson Cayama said.

What can be done to increase men’s access to and utilization of preconception care?

Clearer, more inclusive messaging is a good start, Harris said.

“We need to create messaging that highlights the benefits of preconception care for all people of reproductive age,” Harris said. “There are several recommendations for how and when to deliver preconception care, however, these guidelines are only sometimes consistent, which has hindered providers in delivering these services. Definitive guidance made in partnership with major primary, sexual and reproductive health care professional organizations is needed to prevent confusion. The integration of sexual reproductive health within primary care could also reduce barriers to access.”

Story by Donna Campisano, USF College of Public Health